Gout is a form of inflammatory arthritis that is sometimes called gouty arthritis. It develops in some people who have high levels of uric acid in the blood. That acid can form needle-like crystals in a joint and cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling.

For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Gout may also appear in another low-body joint such as the ankle or knee. Subsequent attacks may occur off and on in other joints, primarily those of the foot and knee, before becoming chronic. 

Eventually, untreated gout can cause other problems. Tophi – painless but disfiguring lumps of crystals formed from uric acid may develop under the skin around joints. The crystals can also form kidney stones. Gout is associated with other serious health risks such as high blood pressure, diabetes, chronic kidney disease and cardiovascular disease, so an overall healthy lifestyle including eating a healthy diet, maintaining a healthy weight and engaging in physical activity is important.

What Are The Stages of Gout?

There are several stages of gout:

Asymptomatic hyperuricemia is the period prior to the first gout attack. There are no symptoms, but blood uric acid levels are high and crystals are forming in the joint.

Acute gout, or a gout attack, happens when something (such as a night of drinking) causes uric acid levels to spike or jostles the crystals that have formed in a joint, triggering the attack. The resulting inflammation and pain usually strikes at night and intensifies over the next 8 to 12 hours. The symptoms will begin to ease after a few days and will probably be completely gone in a week or 10 days. Some people never experience a second attack, but an estimated 60 percent of people who have a gout attack will have a second one within a year. Overall, 84 percent may have another attack within three years.

Interval gout is the time between attacks. Although there’s no pain, the gout isn’t gone. Low-level inflammation may be damaging joints. This is the time to begin managing gout – via lifestyle changes and medication – to prevent future attacks or chronic gout.  

Chronic gout develops in people with gout whose uric acid levels remain high over a number of years Attacks become more frequent and the pain may not go away as it used to. Joint damage occurs, which can lead to a loss of mobility. However, with proper management and treatment, this stage is preventable.